Central California Alliance for Health
Health Services Authorization Coordinator II
Central California Alliance for Health - Merced, California, United States, 95343
Work at Central California Alliance for Health
Overview
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Overview
Health Services Authorization Coordinator II
Location:
Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Santa Cruz County, California This opportunity is available for current Alliance regular and temporary Health Services Authorizations Coordinator I or II's and ECM Care Coordinators. There are thirteen positions available. Accepting applications through Monday, March 17, 2025 by 5:00pm. We have an opportunity as a Health Services Authorization Coordinator II in the Utilization Management Department. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Utilization Management Manager of Authorizations this position: Processes basic to complex incoming treatment and referral authorization requests and verifies member plan eligibility Performs complex research on member authorization requests
THE IDEAL CANDIDATE
Has one year of experience working for The Alliance as a Health Services Authorization Coordinator I
or
any experience working as a Health Services Authorization Coordinator II or Enhanced Care Management Care Coordinator. Has strong interpersonal skills to provide excellent customer service and process authorization requests accurately and timely Has the ability to work in a team-orientated environment and interact with others showing respect and understanding Achievement-driven and highly responsible, with the ability to manage complex authorizations and review requests for approval with precision and efficiency.
WHAT YOU'LL NEED TO BE SUCCESSFUL To read the full position description, and list of requirements click here. Knowledge of:
Medical terminology or billing code procedures Principles and best practices of customer service Standard business office practices and equipment
Ability to:
Verify eligibility information utilizing various organizational sources Interpret, explain and apply processes, policies and procedures Conduct research related to authorization limits and authorization requests Pay close attention to detail and utilize effective organizational skills Produce and maintain accurate records
Education and Experience:
High School Diploma or equivalent A minimum of three years of experience in the health care field, including a minimum of one year of experience performing health services authorization coordination duties An Associate's degree may substitute for one year of general health care experience, or an equivalent combination of education and experience may be qualifying.
OTHER INFORMATION We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams. While some staff may work full-time telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.
The full compensation range for this position is listed by location below.
The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location). Zone 1 (Monterey, San Benito and Santa Cruz) $21.76-$34.83 USD Zone 2 (Mariposa and Merced) $19.80-$31.69 USD
OUR BENEFITS Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance. Medical, Dental and Vision Plans Ample Paid Time Off 12 Paid Holidays per year 401(a) Retirement Plan 457 Deferred Compensation Plan Robust Health and Wellness Program Onsite EV Charging Stations
ABOUT US We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our
Fact Sheet . The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.
Mariposa County, California; Merced County, California; Monterey County, California; San Benito County, California; Santa Cruz County, California This opportunity is available for current Alliance regular and temporary Health Services Authorizations Coordinator I or II's and ECM Care Coordinators. There are thirteen positions available. Accepting applications through Monday, March 17, 2025 by 5:00pm. We have an opportunity as a Health Services Authorization Coordinator II in the Utilization Management Department. WHAT YOU'LL BE RESPONSIBLE FOR Reporting to the Utilization Management Manager of Authorizations this position: Processes basic to complex incoming treatment and referral authorization requests and verifies member plan eligibility Performs complex research on member authorization requests
THE IDEAL CANDIDATE
Has one year of experience working for The Alliance as a Health Services Authorization Coordinator I
or
any experience working as a Health Services Authorization Coordinator II or Enhanced Care Management Care Coordinator. Has strong interpersonal skills to provide excellent customer service and process authorization requests accurately and timely Has the ability to work in a team-orientated environment and interact with others showing respect and understanding Achievement-driven and highly responsible, with the ability to manage complex authorizations and review requests for approval with precision and efficiency.
WHAT YOU'LL NEED TO BE SUCCESSFUL To read the full position description, and list of requirements click here. Knowledge of:
Medical terminology or billing code procedures Principles and best practices of customer service Standard business office practices and equipment
Ability to:
Verify eligibility information utilizing various organizational sources Interpret, explain and apply processes, policies and procedures Conduct research related to authorization limits and authorization requests Pay close attention to detail and utilize effective organizational skills Produce and maintain accurate records
Education and Experience:
High School Diploma or equivalent A minimum of three years of experience in the health care field, including a minimum of one year of experience performing health services authorization coordination duties An Associate's degree may substitute for one year of general health care experience, or an equivalent combination of education and experience may be qualifying.
OTHER INFORMATION We are in a hybrid work environment and we anticipate that the interview process will take place remotely via Microsoft Teams. While some staff may work full-time telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.
The full compensation range for this position is listed by location below.
The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location). Zone 1 (Monterey, San Benito and Santa Cruz) $21.76-$34.83 USD Zone 2 (Mariposa and Merced) $19.80-$31.69 USD
OUR BENEFITS Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance. Medical, Dental and Vision Plans Ample Paid Time Off 12 Paid Holidays per year 401(a) Retirement Plan 457 Deferred Compensation Plan Robust Health and Wellness Program Onsite EV Charging Stations
ABOUT US We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us. Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our
Fact Sheet . The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.